Medi-Plex Healthcare Professionals, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

727-3 Issued in MO

Legal business name

MEDI-PLEX HEALTHCARE PROFESSIONALS, LLC

Doing business as

Medi-Plex Health Professionals

Practice address

1470 S Vandeventer Ave
Saint Louis, MO 63110-2336

Phone

(314) 993-5580

Fax

(314) 991-7745

NPI assigned

Nov 3, 2005

Last updated

Apr 4, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Glenda F White-Kindell, BSN,RN

Title

Ceo/Administrator

Phone

(314) 993-5580

Specialties & licenses 1

Addresses

Other names 1

• Medi-Plex Health Professionals Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972594430. Details of each certification follow.

• CCN 267572 Home health agency · Active · Details

Home health agency certification: CCN 267572

Legal name

MEDI-PLEX HEALTHCARE PROFESSIONALS LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 20, 2002

Last certification

Jan 31, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Nov 22, 1999 in MO

Enrollment address

1470 S Vandeventer Ave
Saint Louis, MO 63110-2336

Listed as

Medi-Plex Healthcare Professionals, LLCCCN 267572 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Jun 20, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

TRP Community Resource Development Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• TRP Community Resource Development Corporation

  dba Wound Care Assistance Program

  • Wound Care Registered Nurse
  • Saint Louis, MO
  • NPI 1164801445
  NPD tax ID

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tawana Spann, PT, MS, GCS

  • Geriatric Physical Therapist
  • Saint Louis, MO
  • NPI 1427326925
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Zahirul Haque, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1578536546

  Home health agency

  Care Compare affiliation
• Piotr Kulikowski, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1053388678

  Home health agency

  Care Compare affiliation
• Tyler Daniel Ragsdale, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1063034197

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649030400000",
    "number": "1972594430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 S VANDEVENTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102336",
            "telephone_number": "314-993-5580",
            "fax_number": "314-991-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 S VANDEVENTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102336",
            "telephone_number": "314-993-5580",
            "fax_number": "314-991-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-PLEX HEALTHCARE PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "WHITE-KINDELL",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "314-993-5580",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN,RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "727-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi-Plex Health Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.